Peking Union Medical College (03:43)
Beijing's Xiehe Hospital struggles to serve thousands of patients, most of whom bypass community health centers in favor of emergency care. Outpatient head Dr. Gey discusses overcrowding. Seriously ill patients compete for the attention of overtaxed doctors.
Addressing Medical Care Inefficiencies (03:52)
During 12 hour days, heart surgeon Dr. Yang sees many patients requiring less serious care. Dr. Gey works on a referral system to fast track patients from community health centers. Mrs. Liu’s consultation lasts 4 minutes; her doctor sees 60 patients in the morning alone.
Building Primary Care in China (03:41)
Government reforms have invested in community health centers to reduce over-dependence on hospitals; clinics are state funded, while hospitals are profit driven. At a Beijing practice, Dr. Gao sees heart bypass patient Mrs. Dong. The program also builds doctor-patient trust.
Meeting China's Healthcare Needs (02:55)
Most young doctors prefer specializing but Dr. Gao enjoys prevention. With a 1:600 doctor-patient ratio, primary care reforms have brought retired doctors back to practice. Improved living standards have increased chronic illness rates; community doctors treat with Western and Chinese medicine.
Barefoot Doctors (04:54)
Dr. Zhang was a rural GP in the 1970s; he studies to update his practice. Dr. Liu is also coming out of retirement to help meet China's healthcare needs. She visits a terminally ill patient; home visits lower hospitalization rates.
Rural Health Insurance Program (03:15)
After privatization in the 1980s, China has returned to a universal healthcare model. Xiao Yang, 6, will undergo heart surgery for constrictive pericarditis— a condition that would have killed him a decade ago.
Extending Healthcare to Rural Communities (02:23)
The Xiao family lives 1,000 kilometers from Beijing. Peasant farmers benefited from Barefoot doctors, but had to pay for healthcare after market reforms during the 1980s. Rural health insurance now pays for 90% of hospital costs.
Price of Life (03:47)
Rural doctors referred Xiao to Harbin's provincial hospital, which referred him to Beijing's Xiehe Hospital. Heart surgery will cost $25,000—equivalent to 8 years of his family’s income. Insurance will cover 70% of his medical costs; they borrowed money for travel.
Xiao Yang's Surgery (03:33)
Xiehe Hospital is profit driven but Xiao's insurance will cover some of treatment costs. His family waits while doctors remove the pericardium.
Poverty from Illness (03:20)
Xiao Yang's operation goes well. The Xiao family cannot afford accommodation, so they wait outside the hospital. They have borrowed money to finance his surgery.
Treating an Aging Population (05:41)
Life expectancy is now 75 years; age related illnesses are the largest healthcare cost. New hospice units will reduce pressure on hospitals and families. Dr. Liu takes a holistic approach and trains volunteers to care for terminally ill patients.
Reducing Financial Burden of Illness (04:03)
Xiao Yang recovers from heart surgery. His family can only afford one sleeper train ticket for the 10 hour journey to Harbin. Government insurance will cover half of the $25,000 treatment; it will take the family years to pay off debts.
China's Healthcare Summary (00:53)
As living standards rise from economic success, health reforms are a first step toward sustainable healthcare.
Credits: China’s Unique Challenge: The People’s Health (00:29)
Credits: China’s Unique Challenge: The People’s Health
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